DESCRIPTION: (Taken from application abstract): Bone age assessment is a procedure frequently performed in pediatric patients in order to evaluate their growth. The radiological examination of skeletal development of a left hand wrist is universally used due to the advantage of simplicity, a minimum of radiation exposure, and the availability of multiple ossification centers for evaluation of maturity. It is an important procedure in the diagnosis and management of endocrine disorders, diagnostic evaluation of metabolic and growth abnormalities, acceleration or decrease of maturation in a variety of syndromes, malformations, and bone dysplasias. It is also consulted in planning an orthopedic procedure. The reference set of data, developed in the 1930's and published in the Greulich and Pyle atlas is not fully applicable for children of today. The set of radiographs does not reflect the standard development particularly of black girls and Caucasian boys. The diagnosis based on matching the diagnosed radiographs with one of the pattern image leads to a discrepancy ranging from 0.4 to 0.9 years. This research project intends to develop a digital atlas with a large standard set of normal hand and wrist radiographs and associated measurements which will form the basis for a computer-assisted bone age assessment. In particular, the research will investigate three hypotheses: (1) New reference set of c@cally normal images will serve as a digital hand atlas. (2) Computer-assisted assessment of skeletal development will extract radiological findings from a patient image and allow for their comparison with corresponding values extracted from the digital atlas serving as an updated set of reference images. (3) Database system will archive image data and radiological findings and allow their access from clinical workstations. In order to test these hypotheses we set forth the following six specific goals: A. Bone age assessment methodology and software development. B. Software development for the user interface and interactive communication. C. Selection of the set of reference images and clinical images for the database system. D. Software development for a digital hand atlas. E. Database design and implementation. F. Clinical evaluation of the performance of the computerized bone age assessment. By the end of this study there will be a medically accepted standard set of digital hand atlases able to be used as a reference. It will remove the disadvantages of the currently used one, incomplete and out-of-date. A computer-aided image analysis will permit the diagnosis to be standardized and become more objective and reproducible., All findings (radiological and clinical) will be stored in a database for future reference and for improvement of the performance of computer-assisted bone age assessment.